BILLING NEWS

Expansion of Radiology and Cardiology Notification/Prior Authorization Protocols to All Savers Plans (Offered Off-exchange) - Effective April 1, 2017

Effective April 1, 2017, care providers must provide notification prior to scheduling a planned service that is subject to UnitedHealthcare’s Outpatient Radiology Notification/Prior Authorization Protocol and Cardiology Notification/Prior Authorization Protocols for a UnitedHealthcare All Savers (offered off-exchange) member. These members can be identified by their ID cards. These protocols include a prior authorization requirement that applies when a UnitedHealthcare member’s benefit document requires health services to be medically necessary to be covered. Once notification has been received, UHC will conduct a clinical coverage review if the member’s benefit document requires health services to be medically necessary to be covered.


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INDUSTRY NEWS TAGS: Radiology News, UnitedHealthcare


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